POMS Reference

HI 00901: Hospital Insurance Entitlement

TN 2 (02-91)

A. Process

New entitlement cases are those where a beneficiary was not on the MBR prior to entitlement to HI benefits.

Eligible individuals filing applications can expect to receive their HI cards approximately 6 weeks after the FO adjudicates the claim and forwards it to the PC.

The card will reflect the specific benefits applied for:

  • Part A and Part B,

  • Part A only, or,

  • Part B only.

At the time the MBR is established, the PC sends the beneficiary an award notice which specifies that it may be used as evidence of HI entitlement prior to receipt of the HI card.

After the MBR is established, the information is passed to the HI master tape (daily), and the HI card is issued (weekly).

B. Procedure

Take no action concerning nonreceipt of HI cards until 6 weeks after the claim was forwarded to the PC.

If the PC requested additional development, allow 6 additional weeks from the date the development was forwarded to the PC before taking any action.

C. References

Non-receipt Cases: HI 00901.225

Non-receipt Cases - RRB Involvement: HI 00901.165